@article{01JQBGZ245845FWC6ZEARS7D95,
  abstract     = {{Objectives: To assess trends in surgical site infection (SSI) incidence in cardiosurgery following a quality improvement initiative in infection prevention and control (IP&C). Methods: This is a historical cohort study encompassing a 10-year surveillance period (2014-2023) in a cardiosurgical department in a multi-organ transplant center. The study encompassed three periods: a baseline period (Phase_1: January 2014-December 2018); an implementation phase covering quality improvement initiatives targeting various aspects of IP&C including organizational factors, pre-operative, intra-operative, post-operative measures, and post-hospitalization care (Phase_2: January 2019-June 2021); a post-implementation phase (Phase_3: July 2021-September 2023). A general linear mixed model was used to assess differences in SSI rates between distinct phases, adjusted for length of hospitalization, American Society of Anaesthesiologists (ASA) physical status classification, and Diagnostic-Related Groups (DRG) weight. The latter two were used as random effects. Results are reported as odds ratios [OR] with 95% confidence interval [CI]. Results: All cardiac surgery patients were included (n = 5851). A total of 208 patients developed SSI (3.5 %). SSI incidence for phase_1, phase_2 and phase_3 were 4.5 %, 4.1 %, and 1.2 %, respectively. The mixed model regression analysis indicated that, compared with the reference period (Phase1), SSI risk did not drop during the implementation phase (OR 0.81, 95 % CI 0.59-1.13, P < 0.001 vs. reference period). A decrease in SSI risk was observed during the post-implementation phase (OR 0.19, 95 % CI 0.11-0.32) CONCLUSIONS: A quality improvement initiative encompassing measurements at all levels potentially impacting SSI risk was implemented over a 2.5 years period. While no risk reduction was observed during the implementation phase, a significant reduction in SSI risk took place in the post-implementation phase. Implications for clinical practice: This study suggests that considerable time may be required to achieve a substantial SSI risk reduction. We assume this may be attributed to the time required to achieve appropriate adherence with IP&C protocols.}},
  articleno    = {{103926}},
  author       = {{Conoscenti, Elena and Enea, Giuseppe and Deschepper, Mieke and Huis in 't Veld, Diana and Campanella, Maria and Raffa, Giuseppe and Ragonesi, Barbara and Mularoni, Alessandra and Mattina, Alessandro and Blot, Stijn}},
  issn         = {{0964-3397}},
  journal      = {{INTENSIVE AND CRITICAL CARE NURSING}},
  keywords     = {{Cardiac surgery,Healthcare-associate infection,Infection prevention and control,Surgical site infection,Quality improvement,HEALTH-CARE,PREVENTION,MANAGEMENT,IMPLEMENTATION,INTERVENTIONS,BUNDLE}},
  language     = {{eng}},
  pages        = {{9}},
  title        = {{A quality improvement program to reduce surgical site infections after cardiac surgery : a 10-year cohort study}},
  url          = {{http://doi.org/10.1016/j.iccn.2024.103926}},
  volume       = {{87}},
  year         = {{2025}},
}

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